European Health Insurance Card (EHIC)

The EHIC or "Health Card" enables holders to access medical resources when travelling outside of their EU country of residence...

European citizens and residents travelling within the European Economic Area, (i.e. the European Union, Norway, Iceland and Liechtenstein) and Switzerland, for private or professional reasons are entitled to a European Health Insurance Card (EHIC), which simplifies the procedure when receiving medical assistance during their stay in a member state.

The EHIC entitles the holder to the same treatment at the same cost as a national of that country. For example, if medical care is provided free of charge in the member state where treatment is required, the claimant will be entitled to free medical care on presentation of the card or an equivalent document. However if a fee is normally applicable, this may need to be paid at the time of treatment.

Note: Rule changes in 2014 now means that it is generally not possible to apply for reimbursement of medical fees normally paid by a resident or citizen of the treating country, even if a patient would normally pay nothing in their home country. However, the implementation of this change varies from country to country so it is advisable to confirm this with your health insurer upon returning home.

The card is only valid for state provided services and not private hospitals or treatments.

It is also not an alternative to travel insurance as it only covers medically necessary services.

Note: Third-country nationals (from outside the EU/EEA) resident in the EU and holding an EHIC cannot use their EHIC in Norway, Liechtenstein or Switzerland. In Iceland, non EU/EEA nationals are only covered for emergency treatment. Holders of an EHIC in Denmark will only be eligible for free treatment in a public hospital in the event of:

A sudden illness

An unexpected aggravation of a chronic condition

An emergency

Childbirth

The Card

Cards are issued by the institution that provides health insurance in the country of residence. The only personal information on the EHIC is the card holder's surname and first name, personal identification number and date of birth. The card does not contain medical data. It contains the same information in all countries where it is issued.

The card validity period varies from country to country.

Applying for a card

Many EU countries issue the EHIC by printing the distinctive EU symbol and other relevant information on the reverse side of the standard-issue national health card or its equivalent. For those countries that require a separate application, the Europa website publishes the application process applicable to each EEC member state and Switzerland.

EHIC Smartphone Application

The European Commission (Directorate General Employment, Social Affairs and Inclusion) has developed a useful multi-language smartphone application which gives details of how to use the EHIC in different countries within the EU. It summarises the treatments, costs, procedure for reimbursement and emergency numbers.

The EHIC in Spain

The EHIC is called a Tarjeta Sanitaria Europea (TSE) in Spain. It allows legal residents of Spain to benefit from emergency medical treatment and care when temporarily in a member country.

Anyone covered by the Spanish social security system or a system is entitled to a TSE.

Residents of Spain can apply to the local Social Security Service and Information Centre (CAISS) for the card. No online application is available.

Note: The TSE cannot be used in Spain to make medical claims. The EHIC (TSE) is for use when visiting a member state other than the country of residence where the card has been issued. That means a resident of Spain with a TSE may use it while travelling in other EU/EEA countries.

Foreign nationals permanently resident of Spain paying into the Spanish social security system must obtain their EHIC (TSE) in Spain; the card will not be issued by the applicant's country of origin.

Non-residents Claiming in Spain

Doctors and Dentists:Present the EHIC card immediately and ensure that the doctor is not a private physician; there is no refund system for private treatment unless there is a private insurance policy in effect. Dentistry is not usually covered by the health service and as such fees will not be refunded.

Prescriptions: State (EEA) pensioners (with proof of status) are eligible for free prescriptions, all other cases must pay up to 40 percent of the total cost.

Hospital Treatment: Confirm that the treating hospital is not private; otherwise the patient is liable for the entire treatment cost. Present the EHIC upon arrival.

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